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General NPI Number Information
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NPI Number | 1063457737
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Entity Type | Individual
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Provider Name | DIMITRIOS T DIAMANDIDIS MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 2650 N TENAYA WAY STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89128
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Country | US
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Telephone | 702-240-0088
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Fax | 702-240-3049
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Provider Business Mailing Address
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Address Line | PO BOX 98978
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City | LAS VEGAS
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State | NV
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Zip | 89193-8978
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 8782
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License Number State | NV
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